Response to steroids in de novo autoimmune hepatitis after liver transplantation.

摘要: Abstract Graft dysfunction associated with autoimmune phenomena has been recently described in liver transplant recipients without previous disease. However, the natural history, diagnostic criteria, and definitive therapeutic approach of de novo hepatitis ( AIH) are poorly understood. We report 12 cases AIH 27.9 ± 24.5 months after transplantation: outcome 7 patients treated steroids is compared a group 5 nontreated patients. Nontreated lost graft 5.8 2.6 from onset. All were alive 48.4 14 (29-65) onset, none them graft. relapsed relation to steroid tapering. presented an atypical antiliver/kidney cytosolic autoantibody, classical autoantibodies 10 cases. Histological study showed several degrees lobular necrosis inflammatory infiltrate. HLA antigen frequencies matching 2 control groups (16 orthotopic transplantation [LTX] 929 healthy blood donors); higher prevalence HLA-DR3 (54.5% vs. 25.9%, P = .04) than controls, which was not observed LTX AIH. In conclusion, this new disease should be included differential diagnosis unexplained dysfunction. addition, treatment results dramatically improved outcome. maintenance therapy usually required. (H EPATOLOGY .)